The results of a 7-year retrospective study(1998-2004)frompatch testing with the European Standard Series(ESS)establishingthe frequency of sensitization in a contact dermatitisclinic in Israel are presented.23 allerge...The results of a 7-year retrospective study(1998-2004)frompatch testing with the European Standard Series(ESS)establishingthe frequency of sensitization in a contact dermatitisclinic in Israel are presented.23 allergens were patch tested on 2156 patients,1462 females(67.8%)and 694 males(32.2%)-.Atopy and asthma were present in 21.9%of the patients.One or more allergic reactions were observed in 937 patients(43.5%).The highest yield of patch test positives from the 1076 positive reactions were obtained from nickel sulfate(13.9%),fragrance mix(7.1%),potassium dichromate(3.8%),Balsam of Peru(3.6%),CL +Me-isothiazolinone(3.4%)and cobaltchloride(3.4%).Allergens which produced the least amount of positive results were primin and clioquinol.Allergic contact dermatitis(ACD)was established in 32.8%,whereas occupationally related allergic(8.0)and irritant contact dermatitis(5.6%)affected a total of 13.6%of the cases studied.The most common clinical forms of dermatitis were chronic dermatitis(47.7%)followed by acute dermatitis(22.8%),and lichenification and hyperkeratosis(7.9%).The hands(30.7%),face and neck(23.9%)and extremities(11.3%)were the most frequently affected areas.Four allergens in our study differed from the top 10 allergens in Europe namely:Cl +Me-isothiazolinone,formaldehyde,4-tert-butylphenol formaldehyde resin and sesquiterpene lactone mix reflecting an existing difference in environmental exposure.Our study is the first to provide data on the frequency of sensitization and important allergens in the aetiology of ACD in Israel.In spite of the existing differences with Europe,we conclude that ESS is an appropriate screening system for the diagnosis of ACD in Israel.展开更多
Background: Anakinra, a recombinant human form of interleukin-1 receptor antagonist, is used to treat patients with active rheumatoid arthritis (RA). Objectives: To report five patients with cutaneous adverse drug rea...Background: Anakinra, a recombinant human form of interleukin-1 receptor antagonist, is used to treat patients with active rheumatoid arthritis (RA). Objectives: To report five patients with cutaneous adverse drug reactions due to anakinra and to evaluate the histopathological and immunohistochemical findings with the aim of understanding the possible mechanisms involved. Methods: Five patients of a series of 10 patients with RA undergoing treatment with anakinra in a clinical trial presented inflammatory lesions at the anakinra injection sites. In each case, clinical features were recorded and skin biopsy specimenswere obtained. In one patient sequential biopsy specimens were obtained from skin lesions at different stages of development. Tissue sections of the biopsy specimens were stained with haematoxylin and eosin and May-Grünwald-Giemsa, and were immunoreacted with antibodies to leucocyte common antigen, CD68, CD3, CD45RO, CD20 and CD45RA. Results: The onset of reaction was within the first month of treatment and appeared as well-defined erythema and oedema involving the injection sites. In two patients the treatment had to be discontinued because of the skin reaction, and in one patient it was associated with systemic involvement. All biopsy specimens exhibited marked dermal oedema and a lichenoid dermal infiltrate composed mainly of lymphomononuclear cells with prominent populations of eosinophils and large CD68+dermal macrophages and an increase in the number ofmast cells, which were spindle shaped in a significant proportion. Conclusions: Cutaneous toxicity is a frequent, usually well-tolerated complication of treatment with anakinra in patients with RA, although in some cases it can be associated with systemic involvement. The most relevant histopathological findings include dermal oedema and a lichenoid, perivascular and periadnexal predominantly lymphomononuclear infiltrate, with many eosinophils and the presence of enlarged CD68+macrophages. These findings resemble those seen in skin reactions in pa展开更多
Contact dermatitis around a tracheostoma is quite rare. So far, there have been only 2 reports about this in medical literature. We, in this study, report herewith contact dermatitis in a 61-year-old Japanese man arou...Contact dermatitis around a tracheostoma is quite rare. So far, there have been only 2 reports about this in medical literature. We, in this study, report herewith contact dermatitis in a 61-year-old Japanese man around a tracheostoma due to salbutamol sulfate and Aldecin . The patient used inhaled Sultanol and Aldecin for the treatment for allergic asthma. On examination, itwas found that there was lichenified, exudative erythema with pigmentation around the tracheostoma. Patch testing with 1% aq. Sultanol and Aldecin revealed a positive reaction. Furthermore, patch testing for salbutamol sulfate 1% pet. also showed positive reaction. Although the contact allergen of our patient has not been fully determined (beclomethasone or other ingredients), this must be the first reported case of double contact dermatitis around a tracheostoma from salbutamol and Aldecin .展开更多
文摘The results of a 7-year retrospective study(1998-2004)frompatch testing with the European Standard Series(ESS)establishingthe frequency of sensitization in a contact dermatitisclinic in Israel are presented.23 allergens were patch tested on 2156 patients,1462 females(67.8%)and 694 males(32.2%)-.Atopy and asthma were present in 21.9%of the patients.One or more allergic reactions were observed in 937 patients(43.5%).The highest yield of patch test positives from the 1076 positive reactions were obtained from nickel sulfate(13.9%),fragrance mix(7.1%),potassium dichromate(3.8%),Balsam of Peru(3.6%),CL +Me-isothiazolinone(3.4%)and cobaltchloride(3.4%).Allergens which produced the least amount of positive results were primin and clioquinol.Allergic contact dermatitis(ACD)was established in 32.8%,whereas occupationally related allergic(8.0)and irritant contact dermatitis(5.6%)affected a total of 13.6%of the cases studied.The most common clinical forms of dermatitis were chronic dermatitis(47.7%)followed by acute dermatitis(22.8%),and lichenification and hyperkeratosis(7.9%).The hands(30.7%),face and neck(23.9%)and extremities(11.3%)were the most frequently affected areas.Four allergens in our study differed from the top 10 allergens in Europe namely:Cl +Me-isothiazolinone,formaldehyde,4-tert-butylphenol formaldehyde resin and sesquiterpene lactone mix reflecting an existing difference in environmental exposure.Our study is the first to provide data on the frequency of sensitization and important allergens in the aetiology of ACD in Israel.In spite of the existing differences with Europe,we conclude that ESS is an appropriate screening system for the diagnosis of ACD in Israel.
文摘Background: Anakinra, a recombinant human form of interleukin-1 receptor antagonist, is used to treat patients with active rheumatoid arthritis (RA). Objectives: To report five patients with cutaneous adverse drug reactions due to anakinra and to evaluate the histopathological and immunohistochemical findings with the aim of understanding the possible mechanisms involved. Methods: Five patients of a series of 10 patients with RA undergoing treatment with anakinra in a clinical trial presented inflammatory lesions at the anakinra injection sites. In each case, clinical features were recorded and skin biopsy specimenswere obtained. In one patient sequential biopsy specimens were obtained from skin lesions at different stages of development. Tissue sections of the biopsy specimens were stained with haematoxylin and eosin and May-Grünwald-Giemsa, and were immunoreacted with antibodies to leucocyte common antigen, CD68, CD3, CD45RO, CD20 and CD45RA. Results: The onset of reaction was within the first month of treatment and appeared as well-defined erythema and oedema involving the injection sites. In two patients the treatment had to be discontinued because of the skin reaction, and in one patient it was associated with systemic involvement. All biopsy specimens exhibited marked dermal oedema and a lichenoid dermal infiltrate composed mainly of lymphomononuclear cells with prominent populations of eosinophils and large CD68+dermal macrophages and an increase in the number ofmast cells, which were spindle shaped in a significant proportion. Conclusions: Cutaneous toxicity is a frequent, usually well-tolerated complication of treatment with anakinra in patients with RA, although in some cases it can be associated with systemic involvement. The most relevant histopathological findings include dermal oedema and a lichenoid, perivascular and periadnexal predominantly lymphomononuclear infiltrate, with many eosinophils and the presence of enlarged CD68+macrophages. These findings resemble those seen in skin reactions in pa
文摘Contact dermatitis around a tracheostoma is quite rare. So far, there have been only 2 reports about this in medical literature. We, in this study, report herewith contact dermatitis in a 61-year-old Japanese man around a tracheostoma due to salbutamol sulfate and Aldecin . The patient used inhaled Sultanol and Aldecin for the treatment for allergic asthma. On examination, itwas found that there was lichenified, exudative erythema with pigmentation around the tracheostoma. Patch testing with 1% aq. Sultanol and Aldecin revealed a positive reaction. Furthermore, patch testing for salbutamol sulfate 1% pet. also showed positive reaction. Although the contact allergen of our patient has not been fully determined (beclomethasone or other ingredients), this must be the first reported case of double contact dermatitis around a tracheostoma from salbutamol and Aldecin .
